Polypharmacy in glaucoma management: a narrative review

Glaucoma is a leading cause of irreversible blindness worldwide. Treatment for glaucoma is typically lifelong and often requires multiple antiglaucoma medications (polypharmacy) to adequately control intraocular pressure, prevent disease progression, and preserve vision. While polypharmacy can enhance disease management, it also raises concerns about its potential long-term negative effects on patients; METHODS: This narrative review synthesizes recent literature from PubMed, ScienceDirect, and references published between January 2015 and October 2025 to examine the impact of polypharmacy on outcomes in glaucoma patients; RESULTS: Evidence suggests that polypharmacy is common in glaucoma care (ranging from 42% to 74%) and is linked to lower quality of life, higher healthcare costs, complex adherence challenges, increased risk of ocular surface disease, and potentially less favorable surgical outcomes; CONCLUSIONS: These findings underscore the importance of balancing effective intraocular pressure reduction with minimizing medication burden through individualized management strategies. Further prospective longitudinal research is needed to clarify the longterm effects of polypharmacy in glaucoma care.